title: Comparison of optics and performance of a distal sensor high definition cystoscope, a distal sensor standard definition cystoscope, and a fiberoptic cystoscope.
abstract: OBJECTIVE
  To evaluate performance characteristics and optics of a new generation high-definition distal sensor (HD-DS) flexible cystoscope, a standard-definition distal sensor (SD-DS) cystoscope, and a standard fiberoptic (FO) cystoscope.
  
  
  METHODS
  Three new cystoscopes (HD-DS, SD-DS, and FO) were compared for active deflection, irrigation flow, and optical characteristics. Each cystoscope was evaluated with an empty working channel and with various accessories. Optical characteristics (resolution, grayscale imaging, color representation, depth of field, and image brightness) were measured using United States Air Force (USAF)/Edmund Optics test targets and illumination meter. We digitally recorded a porcine cystoscopy in both clear and blood fields, with subsequent video analysis by 8 surgeons via questionnaire.
  
  
  RESULTS
  The HD-DS had a higher resolution than the SD-DS and the FO at both 20 mm (6.35 vs 4.00 vs 2.24 line pairs/mm) and 10 mm (14.3 vs 7.13 vs 4.00 line pairs/mm) evaluations, respectively (P <.001 and P <.001). Color representation and depth of field (P = .001 and P <.001) were better in the HD-DS. When compared to the FO, the HD-DS and SD-DS demonstrated superior deflection up and irrigant flow with and without accessory present in the working channel, whereas image brightness was superior in the FO (P <.001, P = .001, and P <.001, respectively). Observers deemed the HD-DS cystoscope superior in visualization in clear and bloody fields, as well as for illumination.
  
  
  CONCLUSIONS
  The new HD-DS provided significantly improved visualization in a clear and a bloody field, resolution, color representation, and depth of field compared to SD-DS and FO. Clinical correlation of these findings is pending.
authors.affiliation: Department of Urology, University of California-Irvine, Orange, CA. Electronic address: AchimLusch@aol.com.
authors.forename: Achim
authors.initials: A
authors.lastname: Lusch
authors.forename: Michael A
authors.initials: MA
authors.lastname: Liss
authors.forename: Peter
authors.initials: P
authors.lastname: Greene
authors.forename: Corollos
authors.initials: C
authors.lastname: Abdelshehid
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Menhadji
authors.forename: Philip
authors.initials: P
authors.lastname: Bucur
authors.forename: Reza
authors.initials: R
authors.lastname: Alipanah
authors.forename: Elspeth
authors.initials: E
authors.lastname: McDougall
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000818:Animals; D020684:Cystoscopes; D003558:Cystoscopy / Q000295:instrumentation; D004867:Equipment Design; D005336:Fiber Optic Technology; D006801:Humans; D008027:Light; D013552:Swine